The aims of this study are to characterize a large sample of employment based health care contracts and to determine how insurance design and vendor risk-sharing arrangements affect the use and expenditures of behavioral health care services. We will identify those individuals who are users of intensive services (hospitalizations, intensive outpatient services or partial hospital services) for special study. Finally, we will develop measures to examine the quality of health care across contracts. To accomplish these aims we will review approximately 1,000 contracts held by between a specific managed behavioral health care vendor as of January 1, 1997. We will gather all behavioral mental health claims filed under these contracts for the relevant contract year, and for the intensive users we will (where possible) obtain their medical, surgical and pharmaceutical claims. We will use the Standard Industry Code (SIC) and other data to characterize the firms who purchase these contracts. We will use data from the Area Resource File, the U.S. census and other sources to characterize the market areas where contracts are in effect. We will develop statistical models to examine the relationship between utilization and expenditures under a contract with respect to contract characteristics, firm characteristics and market characteristics.